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Thanks for all that great, insider info Asphyxia! It's been so long since I had to go through all that, I'd forgotten a lot of it.
Originally posted by
asphyxia
I have a friend that worked for SSDI as a claims reviewer. He was the person that read through the applications and all the supporting medical documentation to determine if the person was eligible or not to receive SSDI. He was actually encouraged to
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I have a friend that worked for SSDI as a claims reviewer. He was the person that read through the applications and all the supporting medical documentation to determine if the person was eligible or not to receive SSDI. He was actually encouraged to approve as many people as possible. At his office, no one was ever automatically denied. The only people that got denied were either ineligible (e.g.: they wanted disability because they work on their feet all day, and sometimes their back or feet are sore) or the applicant failed to provide additional required documentation within the allotted time frame or missed required doctor's appointments.
I've consulted him and the information he has given me is presented below.
First, he wants you to know that SSDI is an INSURANCE policy that you have been paying premiums for, over your entire employment career. It is specifically for situations in which someone cannot work due to a medical issue. In other words, you paid for it, so you will not be "living off the government." Here is the official definition from the SSA: "The law defines disability as the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months."
To get approved for bipolar disorder, you must provide your medical records from EVERY doctor (he stressed that they MUST be MDs or PhDs, Nurse Practitioners (NPs or APNs) and Physician Assistants (PAs) don't count) that has treated you for it, for as far back as it has been affecting your jobs, but at least the past twelve months. He did say that NPs or PAs can be used as supporting evidence, but not the only evidence. If you haven't seen an MD or PhD, the SSA will pay for you to see one of theirs.
This lists the criteria that must be met. If you meet this criteria, you will get approved. If you do not, there are other factors that will be considered, specifically, your RFC which is your Residual Functional Capacity. This will be determined by an SSA doctor that will look at the Mental Status Exam form that your MD(s) fills out, the supporting documentation in your medical records, and also your age (people under 55 have a VERY hard time getting approved, but that doesn't mean they don't).
One impediment to approval is if the SSA tries to find you a job they feel you are capable and qualified for, this is called skills transfer.
The biggest thing you've got working against you is that you're young, educated, and have had an intellectually challenging career and therefore had to go through the stress to get there. You must show that something changed, and that it is unlikely to improve for at least twelve months.
All that said, don't let any of this scare you! He had an applicant in your age category that was approved for bipolar disorder.
I hope things start going better for you!! If you have any questions, let me know! less
I've consulted him and the information he has given me is presented below.
First, he wants you to know that SSDI is an INSURANCE policy that you have been paying premiums for, over your entire employment career. It is specifically for situations in which someone cannot work due to a medical issue. In other words, you paid for it, so you will not be "living off the government." Here is the official definition from the SSA: "The law defines disability as the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months."
To get approved for bipolar disorder, you must provide your medical records from EVERY doctor (he stressed that they MUST be MDs or PhDs, Nurse Practitioners (NPs or APNs) and Physician Assistants (PAs) don't count) that has treated you for it, for as far back as it has been affecting your jobs, but at least the past twelve months. He did say that NPs or PAs can be used as supporting evidence, but not the only evidence. If you haven't seen an MD or PhD, the SSA will pay for you to see one of theirs.
This lists the criteria that must be met. If you meet this criteria, you will get approved. If you do not, there are other factors that will be considered, specifically, your RFC which is your Residual Functional Capacity. This will be determined by an SSA doctor that will look at the Mental Status Exam form that your MD(s) fills out, the supporting documentation in your medical records, and also your age (people under 55 have a VERY hard time getting approved, but that doesn't mean they don't).
One impediment to approval is if the SSA tries to find you a job they feel you are capable and qualified for, this is called skills transfer.
The biggest thing you've got working against you is that you're young, educated, and have had an intellectually challenging career and therefore had to go through the stress to get there. You must show that something changed, and that it is unlikely to improve for at least twelve months.
All that said, don't let any of this scare you! He had an applicant in your age category that was approved for bipolar disorder.
I hope things start going better for you!! If you have any questions, let me know! less
Your friend sounds very nice, and like they really tried to help people. Sometimes we do get cynical when dealing with government workers so often, it was nice to be reminded that we shouldn't be so close-minded about the workers either!
